Medicare Part D

Medicare is divided into various parts such as Medicare Part A, Part B, Medicare Advantage (Part C), Medicare Part D, and Medicare Supplement plans. Each Part covers certain healthcare costs and services. Medicare Part D is the Medicare part that offers coverage for prescription drugs, and you can get a standalone plan that works with your Original Medicare (Part A and B) coverage. You can also get prescription drug coverage by enrolling in a Medicare Advantage plan that offers prescription drug coverage.

There are different types of part D plans that are offered by Medicare-approved private insurance companies. However, to enroll in Part D, you must be enrolled in Medicare Part A and/or Part B.

What Does it Cover?

The type of prescription drugs covered varies depending on the plan and the insurer. However, Part D providers are legally required to cover drugs in certain categories. The list of drugs a Part D plan covers is included in a list known as a Formulary. The drugs are then separated into groups, also known as tiers, based on cost. Before you purchase a Part D plan, it is important to confirm if the plan covers the type of prescription medication you need and what tier it may fall in.

The lowest tier contains preferred generic medications, which are usually the cheapest drugs. The highest tier contains brand name or specialty medications.

To discuss its coverage even further, Medicare mandates Part D plans to cover at least two prescription medications in each category. Part D plans also must include coverage for most, if not all of the prescription drugs in categories such as antipsychotics, HIV/AIDS medications, anticancer treatment drugs, antidepressants, immunosuppressants, and anticonvulsants.

Part D plans, on the other hand, do not cover specific drugs, such as dietary supplements, weight control, hair loss treatments, cosmetic drugs, and over-the-counter medications.

Cost

Depending on the insurer and the extent of drug coverage being offered, Part D plans have a wide variance in how much they cost. While the national average as of 2021 is around $30, they can be lower than $10 or as high as $100. What you pay in premiums can also be determined by how high your income is.

Part D plans also have a deductible. As of 2021, this deductible cannot exceed $445, but do note that each plan’s deductible will vary, and some may even have a $0 deductible.

To learn more about Medicare Part D and if it’s a good option for your healthcare needs, reach out to MedSup for Seniors today!

Review Options and Get Your Questions Answered—Call MedSup for Seniors